Miguel Barraza, 17, of San Jose, and his mother, Maria Magdalena Nevarez, of San Jose, wait to see a doctor for a Whooping cough vaccine at Tran Medical Clinic in San Jose on Sept. 14, 2011. Nevarez said two previous locations would not accept Medi-Cal for the Whooping cough vaccine, which is required for school-age children. (Maria J. Avila Lopez)

Miguel Barraza, 17, of San Jose, and his mother, Maria Magdalena Nevarez, of San Jose, wait to see a doctor for a Whooping cough vaccine at Tran Medical Clinic in San Jose on Sept. 14, 2011. Nevarez said two previous locations would not accept Medi-Cal for the Whooping cough vaccine, which is required for school-age children. (Maria J. Avila Lopez)

A simple message reading "No TDAP No Shot No School" is posted in front at El Dorado Middle School where a student and her family walk past in Concord, Calif., on Wednesday, Sept. 14, 2011. (Susan Tripp Pollard/Staff)

With state deadlines looming — and some passing this week — California schools are fervently hounding teenagers to get vaccinated against whooping cough before they are evicted from class.

San Jose Unified has been making robo-calls every day. Fremont Union high schools make personalized calls and give advice on clinics. Campus billboards warn students they need to get a shot to stay in school. Oakland High School will hold a vaccination clinic Friday, in hopes of reaching some of the 2,000 noncompliers.

“Short of having a skywriter up in the air, we’re doing everything we can think of,” said Greg Louie, associate principal at Santa Teresa High in San Jose, where 130 students this week are getting pulled into the office to reinforce the message.

Wednesday marked the first vaccination deadlines in Santa Clara County for four school districts that began school Aug. 15. But none reported plans to turn away students on Thursday.

One of them, San Jose Unified, switched strategies on Wednesday, its deadline. It sent home about 250 permission slips with unvaccinated students. Those returning the slips by Thursday will receive free vaccines Friday by school nurses on campus.

“We expect we’ll be doing three to 20 doses per site,” Melinda Landau, manager for health and family support programs, said. “We really want these kids in school.”

New requirements

Under a new state law, all seventh- through 12th-graders must prove they’ve received a Tdap, or whooping cough, booster in order to attend public or private school. Enforcement begins 30 days from the first day of school, which varies from district to district. But with the date now approaching, officials have stepped up the reminders that many began last spring. School districts have to gather the confirming paperwork so they don’t have to turn away students — and lose state money based on enrollment numbers.

Some districts have declared victory. Mountain View-Los Altos High has all its 3,600-plus students vaccinated. Cupertino Union is 99 percent compliant. But others are still reminding, pestering and threatening students to get the Tdap shot and bring in written proof.

But some parents have been confused about where and when they can get the vaccinations. On Wednesday, Miguel Barraza and his mother Maria Magdalena Nevarez were driving around San Jose seeking a Tdap booster. At Walgreens, they were told their Medi-Cal insurance wasn’t accepted, and they would have to pay $70.

“That was too much,” said Miguel, 17, a student at San Jose Conservation Corps. They then tried the Indian Health Center of Santa Clara Valley but were turned away because it wasn’t their Medi-Cal primary provider. The center refused their offer to pay the standard $15 fee. Accepting payment from a patient registered elsewhere is against Medi-Cal rules, according to Daniela Arcienega of the clinic. Finally, Miguel got his shot at an East San Jose clinic, which billed his insurance.

At least, he said, “it didn’t hurt.”

Other patients say school fliers directed them to clinics that either didn’t offer the vaccine or required physical exams — at a cost of $150 or more — to administer one, Arcienega said. The nonprofit Indian Health Center was so jammed last month it moved in extra benches for patients in its two waiting rooms.

Resurgent illness

Whooping cough cases spiked in summer 2010 and again in winter and are still being reported. So far this year, Santa Clara County has had 145 confirmed, probable or suspect cases, compared with 461 such cases in all of 2010. The disease, which can be fatal to infants and those with weakened immune systems — and extremely debilitating to others — is contagious and is seeing a resurgence.

Until about 60 years ago, whooping cough, also known as pertussis, was a major cause of infant death worldwide. Childhood vaccination reduced its toll, but the disease again gained a foothold in recent years, partly because of reduced vaccination, genetic mutation by the disease and increased reporting.

‘We’re nagging them’

In response, California enlisted schools as its enforcer of vaccinations to boost the immunity that teens initially received through a series of shots as infants and at age 4.

Although that law passed a year ago, enforcement begins this school year.

After Sept. 22, Campbell Union high school students without Tdap certificates will be asked to leave, said Gaylene Hinkle of the district. Campbell Union high schools reached 94 percent compliance on Tuesday. The district has mostly been approaching students, Hinkle said, “We’re nagging them regularly.”

Contact Sharon Noguchi at 408-271-3775.

Vaccination Clinics in Santa Clara County

Santa Clara County Public Health Department, 976 Lenzen Ave., San Jose; for all immunizations, weekdays 8 to 11:30 a.m. and 1 to 4 p.m. On Thursdays for Tdap only, 1 to 4:30 p.m. Charge is $15 per immunization; bring the child’s yellow immunization record card to receive shots. For information, go to www.sccphd.org and click on “Information on Whooping Cough Vaccine Boosters.”